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Impact of Comorbidity on Headache-related Disability
Saunders K, Merikangas K, et al.
Posted: October 2008  
Neurology  2008;70:538-547

Objective:   To assess and compare the extent to which comorbid conditions explain the role disability associated with migraine and other severe headaches.

Methods:   A probability sample of US adults was interviewed. Presence of headaches, other chronic pain conditions, and chronic physical conditions was assessed in a structured interview administered by trained interviewers.

Results:   Eighty-three percent of migraineurs and 70% of persons with other severe types of headache had some form of comorbidity. Compared with headache-free subjects, migraineurs were at significantly increased risk for mental disorders, other pain conditions, and physical diseases. Compared with headache-free subjects, persons with nonmigraine headache were also at significantly increased risk for mental disorders, other pain conditions, and physical diseases. Migraineurs experienced role disability on 25.2% of the last 30 days compared with 17.6% of the days for persons with nonmigraine headaches and 9.7% of the days for persons without headache. Comorbid conditions explained 65% of the role disability associated with migraine and all of the role disability associated with other severe headaches.

Conclusions:   Comorbidity is an important factor in understanding disability among persons with headache.